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Simple steps to prevent cancer

About a third of some of the most common forms of cancer could be prevented through healthy diet, physical fitness, and limiting alcohol intake, the American Institute for Cancer Research and the World Cancer Research Fund say in a new report. About 7.6 million people die from cancer every year worldwide, and 12.7 million new cases are diagnosed. According to the Union for International Cancer Control, a third of cancer cases could be cured through early diagnosis and treatment and 30% to 40% could be prevented. About 340,000 cases of cancer could be prevented annually in the U.S. if more people started eating a varied and healthy diet, started a regimen of physical activity, limited alcohol intake, and maintained a healthy weight, the new report says.

“Physical activity is recommended for people of all ages as a means to reduce risks for certain types of cancers and other non-communicable diseases,” says Tim Armstrong, MD, of the World Health Organization, says in a news release. “In order to improve their health and prevent several diseases, adults should do at least 150 minutes moderate physical activity throughout the week. This can be achieved by simply walking 30 minutes five times per week or by cycling to work daily.”

To reduce cancer risk, people also should quit smoking, avoid excessive sun exposure, and protect themselves against cancer-causing infections.

Tim Byers, MD, MPH, of the Colorado School of Public Health, says scientists urge Americans “to make the simple lifestyle changes of eating healthy food, getting regular physical activity, and maintaining a healthy weight to reduce cancer risk.” The World Cancer Declaration outlines 11 targets it says could be achieved by 2020 to fight cancer. These goals include: significant drops in global tobacco use, obesity, and alcohol intake; universal vaccination programs for hepatitis B and human papilloma virus (HPV); universal availability of effective pain medication; and efforts to dispel misconceptions about cancer. The health organizations say in a detailed report that the most common cancers in the U.S. and Britain are of the breast, colon/rectum, lung, and prostate.

The American Institute for Cancer Research recommends the following cancer-prevention steps.

  • Limit consumption of calorie-dense foods, particularly processed foods high in added sugar, low in fiber, or high in fat.
  • Avoid sugary drinks.
  • Eat more of a variety of vegetables, fruits, whole grains, and beans.
  • Limit consumption of red meats such as beef, pork, and lamb, and avoid processed meats.
  • Limit consumption of salty foods and foods processed with sodium.
  • Dietary supplements for lowering cancer risk are not recommended.
  • Be as lean as possible without becoming underweight.
  • Be physically active for 30 minutes or more every day.
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Eating disorders affect all

With eating disorders on the rise among boys, minorities and younger children, doctors need to keep an eye out for unexpected cases, according to the author of a new report. The stereotype that eating disorders affect only affluent, white teenage girls no longer applies, said David S. Rosen, MD, MPH, who wrote a clinical report on the topic that was published in the December issue of Pediatrics. “It’s also happening to boys, young children, people of color and middle-aged women. It’s more of an equal opportunity disorder,” said Dr. Rosen, a professor of pediatrics, internal medicine and psychiatry at the University of Michigan.

Males, for example, now represent up to 10% of all cases of eating disorders. The number of children younger than 12 who are hospitalized for eating disorders increased 119% from 1999 to 2006, according to an analysis by the Agency for Healthcare Research and Quality cited in the report (www.ncbi.nlm.nih.gov/pubmed/21115584/). Young children who develop eating disorders are more susceptible to serious medical consequences such as stunted growth and organ damage, Dr. Rosen said.

Early intervention recommended

He urges physicians, nurses, parents, school social workers and others to intervene early. Health care professionals should take note when patients, particularly young ones, make derogatory comments about their appearance or talk about going on a diet. The report said screening questions about eating patterns and body image should be asked of all preteens and adolescents.

Fewer than 1% of adolescent girls in the U.S. have anorexia, and 1% to 2% percent have bulimia. Experts estimate that between 1% and 14% of Americans exhibit some physical and psychological symptoms of an eating disorder. Male and female athletes, including gymnasts, runners and wrestlers, and performers, such as dancers and models, may be more at risk.

The report said eating disorders may have more of a genetic link, similar to alcoholism and depression, than previously thought. The discovery that some children may be genetically predisposed to the condition may “help to take away some of the blame or stigma,” Dr. Rosen said. With more children obese, physicians should choose their words carefully when counseling a child about his or her weight, Dr. Rosen said. He sees young patients with eating disorders who claim their problems with food began when their doctor told them to lose weight.

Dr. Rosen recommends that physicians discuss healthy eating practices, not dieting, with patients and focus on a healthy lifestyle, not losing weight. “There’s a perception that, like alcoholism, [an eating disorder] never goes away and that the best you can do is keep it under control,” he said. But if caught early, “most children and teens can expect to recover completely.”

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Smoking is behind one third of rheumatoid arthritis

Smoking accounts for more than a third of cases of the most severe and common form of rheumatoid arthritis, indicates research published online in the Annals of the Rheumatic Diseases. And it accounts for more than half of cases in people who are genetically susceptible to development of the disease, finds the study.

The researchers base their findings on more than 1,200 people with rheumatoid arthritis and 871 people matched for age and sex, but free of the disease. The patients came from 19 health clinics in south and central Sweden, while their healthy peers were randomly selected from the population register. All the participants were aged between 18 and 70. They were quizzed about their smoking habits and grouped into three categories, depending on how long they had smoked. Blood samples were taken to assess all the participants' genetic profile for susceptibility to rheumatoid arthritis and to gauge the severity of their disease, as indicated by their antibody levels.

More than half of those with rheumatoid arthritis (61%) had the most severe form of the disease, which is also the most common form, as judged by testing positive for anticitrullinated protein/peptide antibody (ACPA). Those who were the heaviest smokers – 20 cigarettes a day for at least 20 years – were more than 2.5 times as likely to test positive for ACPA. The risk fell for ex-smokers, the longer they had given up smoking. But among the heaviest smokers, the risk was still relatively high, even after 20 years of not having smoked.

Based on these figures, the researchers calculated that smoking accounted for 35% of ACPA positive cases, and one in five cases of rheumatoid arthritis, overall. Although this risk is not as high as for lung cancer, where smoking accounts for 90% of cases, it is similar to that for coronary artery heart disease, say the authors. Among those with genetic susceptibility to the disease, and who tested positive for ACPA, smoking accounted for more than half the cases (55%). Those who smoked the most had the highest risk.

The authors point out that several other environmental factors may contribute to an increased risk of rheumatoid arthritis, including air pollutants and hormonal factors. But they suggest that their findings are sufficient to prompt those with a family history of rheumatoid arthritis to be advised to give up smoking.

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Sugary juice and soft drinks increase risk of gout

A new study finds that drinking orange juice, soda and other beverages high in the sugar fructose could increase the small risk that middle-age and elderly women have of developing gout. Gout is a painful form of arthritis caused by too much uric acid in the blood. For women in the study who drank two or more servings of these beverages per day, the risk of gout was more than double that for women who drank sugary sodas and juices less than once per month. Because gout is relatively rare among women, the drinks probably contribute only moderately to a woman's chances of developing it. Still, this is the first study linking sodas and sweetened fruit juices to women's gout risk. Previous research found such a link for men.

The study will be published in the Nov. 24 issue of the Journal of the American Medical Association, and is being presented today (Nov. 10) at the American College of Rheumatology annual scientific meeting.

Gout grief

Gout occurs when levels of uric acid in the blood become too high, and uric acid crystallizes around the joints, leading to inflammation, swelling and pain. Foods than can increase the levels of uric acid in the blood include organ meats (such as kidneys and livers), asparagus and mushrooms, according to the Mayo Clinic. Fructose is also known to increase blood uric acid levels, the researchers said. While gout is not common in the United States, the rate of incidences has more than doubled over a 20-year period, from 16 cases per 100,000 Americans in 1977 to 42 per 100,000 in 1996. Over this period, the researchers noted, the population also consumed increasing amounts of soda and other drinks sweetened with fructose.

The new study followed 78,906 women for 22 years, from 1984 to 2006, as part of the Nurses' Health Study. At the beginning of the study, none of the women had gout. By the end, 778 had developed it. Women who drank one serving of soda per day were 1.74 times more likely to develop gout than those who drank less than one serving per month. Those who drank two or more servings per day were 2.4 times more likely to develop gout. Drinking two or more servings of soda per day caused an additional 68 cases of gout per 100,000 women per year, compared with drinking less than one serving of soda per month, the researchers said. Drinking orange juice also increased the risk. Women who drank one serving of orange juice per day were 1.41 times more likely to develop gout, and those who drank two or more servings were 2.4 times more likely to report gout.

Lifestyle and diet

The rise in gout cases is most likely due to changes in lifestyle and diet and an increase in conditions associated with gout, such as metabolic syndrome, said study researcher Dr. Hyon K. Choi of the Boston University School of Medicine. The results held even after the researchers took into account factors that could have influenced the findings, such as age, body mass index and whether the women had gone through menopause, Choi said.

The findings suggest diets to prevent gout should reduce fructose intake, the researchers said.

The study was funded by the National Institutes of Health.

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Osteoperosis may be a paediatric disease

The researchers fed 12 piglets a calcium-rich diet and another 12 piglets a calcium-deficient diet during the first 18 days of their lives. When the researchers examined samples of bone marrow, organs, and hind leg bone at the end of the study, they found that the piglets fed a calcium-deficient diet had compromised bone density and strength. The bone marrow tissue of these same piglets also seemed to be predisposed to become fat cells rather than osteoblasts (bone-forming cells). The presence of fewer osteoblasts during infancy may result in a reduced ability of bones to grow and repair themselves during later years.

Osteoporosis affects an estimated 10 million men and women in the United States, with about 80 percent of cases diagnosed in women. According to the National Osteoporosis Foundation, approximately 34 million additional people are believed to have low bone mass, which places them at increased risk for osteoporosis. Most people who have osteoporosis or low bone mass do not even know they have it, and the first clue is often a fracture associated with a fall or, in severe cases, simply bending over or turning around.

The lead researcher, Dr. Chad Stahl, an associate professor in the Department of Animal Science at North Carolina State University, noted that maintaining good calcium nutrition for children and adolescents is known to be important, but that this recent study “suggests that calcium nutrition of the neonate may be of greater importance to life-long bone health due to its programming effects on mesenchymal stem cells” (bone marrow tissue from which osteoblasts are formed). This idea might cause healthcare professionals “to begin thinking about osteoporosis not so much as a disease of the elderly, but instead as a pediatric disease with later onset.”

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